ACTIONS REQUIRED: When Employees Separate (COBRA Enrollment Process)
This page is designed to assist Department Coordinators in providing Residents/Clinical Fellows and their family members with appropriate information and materials regarding their health & welfare plans upon separation or loss of eligibility.
Whenever an employee separates from UC service, it is extremely important that appropriate COBRA/Conversion continuation materials pertaining to UC health & welfare plans be provided to the employee within the legally required timeframes. Also, plans providing for conversion options require enrollment within 31 days following the date of separation.
1. HEALTH PLANS: COBRA
Actions
Coordinator:
- Provides employee with COBRA enrollment forms, rates, and advises of enrollment deadlines; completes employer section of COBRA forms as appropriate
Employee (Resident/Clinical Fellow):
- Follows steps to enroll in COBRA if desired
Insurance coverage under Blue Cross, Health Net, Vision Service Plans, and Delta Dental ends on the last day of employment or on June 30th for appointments with mid-June end dates. You may, however, continue group coverage in any or all of these plans for up to 18 months under Federal COBRA (the Consolidated Omnibus Budget Reconciliation Act of 1985). If you/your family members exhaust your Federal COBRA period, you may continue coverage for medical only for an addtional 18 months through Cal COBRA, given you remain eligible COBRA beneficiaries.
You have 60 days from the date of separation to enroll in COBRA.
When you elect COBRA coverage, you must enroll and pay separately for each plan you wish to continue (medical, dental and/or vision). It is not required that you retain all coverage and you may elect to continue only one (e.g. medical) while allowing others (e.g. dental and/or vision) to lapse.
Under COBRA, you enroll yourself and your dependents directly with the carrier(s). You will also pay the entire premium plus a small administrative fee (+2%) directly to the carrier(s). Current rates and enrollment forms are available online . Again, you must enroll and pay separately for medical, dental, and/or vision coverage (i.e. this requires 3 forms + 3 checks from you). Administrative services for Blue Cross COBRA and Delta Dental COBRA are performed by UniCare.
If you are considered disabled under Title II or XVI of the Social Security Act upon your separation date, the maximum period of continuation coverage is 29months, as long as you remain continuously disabled. In addition, the California Department of Health Services will pay the private health insurance premiums for certain persons losing employment under some circumstances. Additional information and pertinent phone numbers are available from your Department Representative or the HR Office (476-8093).
FOR MORE INFORMATION
COBRA Forms, Rates, and Plan Addresses
HealthNet COBRA Customer Service Phone number: 1-800-522-0088
UniCare COBRA Customer Service Phone number: 1-800-327-2770 ext 7361
2. LIFE INSURANCE: Conversion
Actions
Employee (Resident/Clinical Fellow):
- Follows steps for conversion if desired
When your life insurance coverage ceases as a result of termination, you may have the right to convert some or all of your life coverage from the group plan to an individual plan. Evidence of your health will not be required to exercise this right of conversion. You must apply in writing and pay the first premium to the insurer within 31 days after the date of your separation. At your option, the amount of your policy may equal or be less than your personal life insurance that ceased under this plan (UCSF at present = $50,000/insured). The premium will be determined by the form and amount of your policy, as well as your class of risk and age on its effective date. Forms for life insurance conversion can be secured from the HR Office (476-8093).
3. LONG TERM DISABILITY INSURANCE (LTD): Conversion
Actions
Employee (Resident/Clinical Fellow):
- Follows steps for conversion if desired
When your long term disability coverage ceases as a result of termination, you may have the right to convert from the group plan to an individual plan. You must apply in writing and pay the first premium to the insurer within 31 days after the date of your separation. Please call the HR Office (476-8093) to secure a packet of information and forms.
4. DEFINED CONTRIBUTION PLANS/403(b)/457(b)
Actions
Employee (Resident/Clinical Fellow):
- Follows steps to request refund or rollover from plan if desired
Please contact Fidelity 30 days or more following your separation date to learn how to request an online refund or rollover from UC’s Defined Contribution Plan or tax-deferred savings plans. 1-866-682-7787, https://netbenefits.fidelity.com